Don’t spend hours trying to develop your own initial assessment form… use mine!

This 7-page nutrition assessment questionnaire was written from the perspective of a non-diet, HAES-aligned, eating disorder dietitian, and I’ve refined it over the course of 6 years working in different outpatient nutrition counseling settings.

This comprehensive assessment can be used for a variety of niches and is perfect for outpatient nutrition counseling practices. It includes questions about health history, eating patterns, exercise patterns, relationship with food and exercise, body image, readiness to change, and relevant family dynamics that may influence the nutrition counseling process.

Pro Tip: Have your new clients complete their nutrition assessment questionnaire prior to your first session so your first session can be spent asking follow up questions, getting to know each other better, and coming up with a plan of action. Of course if you prefer, just ask your new clients these questions during your first session!


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  • Gentle nutrition and weight inclusive nutrition assessment questions

    Detailed and very helpful. I plan on modifying my intake form with a variety of questions from this assessment form.

  • Gentle nutrition and weight inclusive nutrition assessment questions

    I incorporated many of these questions into my nutrition assessment. It helps guide the session along in a nurturing way.

  • Great resource for initial assessment!

    This is a great tool to utilize during initial assessments. The questions help guide conversation during the first meeting and parts can definitely be saved for follow up as well.

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